Opportunity Information: Apply for NCD 21 01
This funding opportunity (NCD 21 01) is a discretionary, cooperative agreement from the National Council on Disability (NCD) to produce a policy-focused report on how state Medicaid programs may be using Quality-Adjusted Life Year (QALY) based cost-effectiveness analyses to make prescription drug coverage decisions. In particular, NCD is looking for a contractor to investigate the extent to which states rely on cost-effectiveness studies from the Institute for Clinical and Economic Review (ICER) that incorporate QALYs, as well as whether states use international drug prices that were themselves influenced by QALY-based assessments abroad. The core purpose is to document where and how these tools are being used in Medicaid decision-making and to assess whether this reliance has affected access to drugs and treatments for Medicaid beneficiaries, especially people with chronic illnesses and disabilities.
The report NCD is seeking is meant to inform federal and state policymakers and Congress by giving them clear, evidence-based insight into how QALY-based methods and related price benchmarking practices may shape coverage, utilization management, and patient access. NCD also intends the report to be useful to patient rights organizations, medical associations, educators, and people with disabilities by translating the policy landscape into understandable findings about health care policies, legislation, and initiatives that can materially affect daily life and health outcomes. A major theme embedded in the announcement is concern that QALY-based valuation, depending on how it is applied, may create barriers to accessing needed medications for individuals whose health status, disability, or chronic conditions can affect how QALY models score the value of treatments.
The work product is expected to do several specific things. First, it must identify which states are using ICER QALY-based cost-effectiveness studies or international price references tied to QALY research when shaping Medicaid prescription drug coverage decisions. Second, it must explain how those studies or prices are being used in practice, such as functioning as a benchmark, an explicit or informal cost-effectiveness threshold, or a supporting justification for preferred drug lists, prior authorization requirements, step therapy protocols, coverage exclusions, or other coverage limitations. Third, the report must examine whether and how reliance on these reports and/or international pricing has impacted actual coverage of drugs and treatments for beneficiaries, with attention to practical access barriers, including delays, denials, or restrictive conditions placed on coverage.
Beyond documenting use and impact, the report must also address alternatives to QALYs. NCD explicitly calls for a discussion of methodological approaches that better incorporate patient values and preferences, which signals an interest in frameworks that do not reduce the value of care to a single metric that can disadvantage certain groups. The final deliverable is expected to include findings and actionable recommendations targeted to the U.S. Department of Health and Human Services, state governments, and Congress. Those recommendations should address any issues uncovered in the research, including policy or administrative barriers to prescription drug access that may be associated with reliance on QALY-based studies or international reference pricing. In short, the project is designed to move from mapping and analysis to concrete policy guidance.
Administratively, this is a single-award opportunity with an expected one award and an award ceiling of $65,000. Eligibility is listed as unrestricted, meaning any type of entity may apply so long as it meets any additional conditions specified in the full Notice of Funding Opportunity. The CFDA number is 92.002, the opportunity was created June 15, 2021, and the original closing date was July 20, 2021. Additional details and official requirements were made available through NCD's website (www.ncd.gov) under the "Funding Opportunities" section and on the NCD home page.Apply for NCD 21 01
- The National Council on Disability in the other (see text field entitled explanation of other category of funding activity for clarification) sector is offering a public funding opportunity titled "Notice of Funding Opportunity: State’s use of Quality-Adjusted Life Year (QALY) - Based Cost-Effectiveness Reports to Inform Medicaid Coverage for Prescription Drugs" and is now available to receive applicants.
- Interested and eligible applicants and submit their applications by referencing the CFDA number(s): 92.002.
- This funding opportunity was created on Jun 15, 2021.
- Applicants must submit their applications by Jul 20, 2021. (Agency may still review applications by suitable applicants for the remaining/unused allocated funding in 2026.)
- Each selected applicant is eligible to receive up to $65,000.00 in funding.
- The number of recipients for this funding is limited to 1 candidate(s).
- Eligible applicants include: Unrestricted (i.e., open to any type of entity above), subject to any clarification in text field entitled Additional Information on Eligibility.
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